Abstract
The type and number of complications was prospectively examined in 1,727 successive TPE treatments in 174 patients over 66 months at a single center. Most treatments were prescribed for thrombotic thrombocytopenic purpura (TTP; 42%), recurrent focal segmental glomerulosclerosis (FSGS; 22%), or myasthenia gravis (MG; 13%). About 57% of treatments used albumin–saline as the replacement solution and 43% used fresh‐frozen plasma (FFP), almost all for TTP. There were 889 complications; 614 treatments (36% of the total) involved a complication. Most complications were minor; there were no deaths. Three treatments (0.2%) were discontinued due to a complication, and 2 (0.1%) required transfer to a higher acuity hospital bed. The most common complications were fever (7.7% of treatments), urticaria (7.4%), and hypocalcemic symptoms (7.3%). 42% of treatments with FFP involved a complication, compared to 30% of treatments using albumin–saline (P < 0.0001). The most common complications with FFP were urticaria (17%) and pruritis (13%); these occurred more commonly than in patients receiving albumin–saline. The most common complications with albumin–saline replacement were hypocalcemic symptoms (8.2%) and mild hypotension (8.1%). Mild and severe hypotension was significantly (P < 0.0001) more common with albumin–saline replacement. TPE is associated with a number of minor complications. Complications occur more commonly with FFP replacement compared to albumin–saline replacement. Pruritis and urticaria occur more commonly with FFP, and hypotension occurs more commonly with albumin–saline. J. Clin. Apheresis, 2007. © 2007 Wiley‐Liss, Inc.